We are recruiting for a Manager, Reimbursement to join our Reimbursement Team.

Summary:

Lead in the supervision of Medicare and Medicaid cost report preparation, review, and audit.  Successful candidate will be a resource to division, provider facility and department staff.  Must understand Medicare and Medicaid reimbursement principles, data sources, and necessary supporting workpapers.  Lead team in continuous improvement initiatives to include redesign of workflow.  

Essential Functions:

• Manages staff including performance management, staff satisfaction, skillset elevation and more.
• Leads in the department’s mission to prepare, review and submit Medicare and Medicaid cost reports.
• Leads in the review of annual rate updates and new reimbursement regulations including cost report changes for all provider types and develop new processes/procedures as necessary to comply with any changes in reporting requirements.
• Leads the oversight and management of internal and external audits.
• Actively participate in continueous improvement inititatives, including study of workflow redesign, identification and deployment of systems soltuions, and  developing workload plans and assignments for staff.
• Review monthly revenue accruals and/or contractual adjustments.
• Train staff in reimbursement tasks and assist in review of staff work, provide input on staff performance appraisals.
• Participate in transaction due diligence and integration of new acquisitions into department processes.
• Reconcile reimbursement settlement accounts for facilities and assist managers in review of Analysts’ reconciliations.
• Provide technical expertise and analytical support for government reimbursement matters.
• Assist in development of policies, procedures, reports, and other tools to improve work product.
• Work directly with Reimbursement department leadership on planning, training, and special projects as necessary.
• Collaborate with others, set priorities, multitask, work well with deadlines and other time pressures.
• Independently manage special projects to completion as assigned.

Knowledge/Skills/Abilities:

• Demonstrated proficiency in Medicare principles of reimbursement, CMS cost reporting requirements, MAC relations and audit process.
• General experience with state Medicaid programs and related reporting requirements.
• Excellent communication, organization, analytical skills, and attention to details and accuracy are required.
• Advanced Excel skills and proficient use of Word, PowerPoint, and other relevant software.  Experience with cost report software is essential.
• Must possess excellent oral/written communication skills.
• Knowedge of GAAP accounting.
• Excellent analytical skills and attention to details and accuracy.
• Excellent oral/written communication skills.

Education:

• Bachelor’s degree in accounting, finance, systems or other degree with equivelent experience.

Experience:

• Minimum 7 to 10 years healthcare reimbursement experience (preferably with multiple providers) with a hospital or hospital chain, consulting or CPA firm, Medicare Administrative Contractor, or similar.
• Experience should include training, supervision, review of reimbursement functions and third party payor accounting.

Depending on candidate’s qualifications we may fill this at a different level.